A 28-year-old patient presents to the emergency department complaining of chest pain, shortness of breath, and a feeling of impending doom. Vital signs are: BP 140/90, HR 110, RR 24, SpO2 98% on room air. ECG and cardiac enzymes are normal. Which of the following is the most likely diagnosis?
Pulmonary embolism
Acute coronary syndrome
Panic attack
Pneumothorax
The correct answer is a panic attack. The patient's symptoms of chest pain, shortness of breath, and a feeling of impending doom are classic presentations of a panic attack. Additionally, the vital signs show tachycardia and tachypnea, which are common during panic attacks due to the body's fight-or-flight response. The normal ECG and cardiac enzymes rule out acute cardiac events.
While acute coronary syndrome can present similarly, the patient's age and normal cardiac workup make this less likely. Pulmonary embolism typically presents with more severe hypoxia and tachycardia. Pneumothorax would likely show decreased breath sounds and oxygen saturation. It's important for emergency nurses to recognize panic attacks while also ruling out life-threatening conditions through appropriate assessments and diagnostics.
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